Provider Demographics
NPI:1124266531
Name:BRUBAKER, KATHERINE SHEA (MED, LPC, RPT)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:SHEA
Last Name:BRUBAKER
Suffix:
Gender:F
Credentials:MED, LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 MAGNOLIA COVE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-2252
Mailing Address - Country:US
Mailing Address - Phone:832-233-5714
Mailing Address - Fax:
Practice Address - Street 1:1308 KINGWOOD DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3146
Practice Address - Country:US
Practice Address - Phone:713-481-2808
Practice Address - Fax:713-481-2805
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16043101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor